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Decreasing Proportion of Americans Has Source of Primary Care

Significant reductions among adults in their 30s, 40s, 50s; decrease for those with no comorbidities

WEDNESDAY, Dec. 18, 2019 (HealthDay News) -- A decreasing proportion of Americans had an identified source of primary care from 2002 through 2015, according to a research letter published online Dec. 16 in JAMA Internal Medicine.

David M. Levine, M.D., M.P.H., from Brigham and Women's Hospital in Boston, and colleagues analyzed data from the Medical Expenditures Panel Survey from 2002 to 2015 to examine changes in receipt of primary care over time.

The researchers found that from 2002 to 2015, there was a decrease in the proportion of adults with an identified source of primary care from 77 to 75 percent (odds ratio, 0.90). Receipt of primary care decreased for every decade of age except for individuals in their 80s; statistically significant reductions were seen for individuals in their 30s, 40s, and 50s. Receipt of primary care decreased for every decade of age among Americans with no comorbidities. For Americans with at least three comorbidities, having primary care was generally stable. Factors associated with reduced likelihood of having primary care included calendar year (adjusted odds ratio [aOR], 0.97 for each year); male sex (aOR, 0.59); Latino, black, and Asian race/ethnicity (aORs versus white, 0.80, 0.88, and 0.67, respectively); not having insurance (aOR, 0.29 versus private insurance); and Southern U.S. Census Bureau region (aOR, 0.53).

"To improve Americans' health in an efficient and cost-effective manner, policy makers should prioritize increasing the proportion of Americans with primary care," the authors write.

One author disclosed financial ties to Biofourmis to perform a machine learning study of home-based acute care monitoring.

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